There has been a lot written about the issue of what is popularly known as sex addiction.  This has been promulgated early on within the addiction and recovery movement, and has more lately been taken up by mainstream media.  While the label floats around and is easily applied to any number of sexual behaviors, there exists no consensus in the therapeutic community about what constitutes sex addiction.  I choose not to use in in my practice not because I don’t believe there is such a thing as sex addiction, it’s just not something I care to diagnose without a clear clinical picture of just what it is.  That being said, I work with men who exhibit what is less commonly known as problem sexual behavior, compulsive sexual behavior, or what Douglas Braun-Harvey and Michael Vigorito refer to as Out of Control Sexual Behavior.  

Possible Signs of Problem or Out of Control Sexual Behavior:

1. A pattern of sexual behavior that causes a significant amount of emotional distress in a person, particularly as it escalates or progresses.

2. A tendency to be socially or emotionally more isolated as the behavior progresses or persists.

3. The behavior tends to escalate in terms of its degree or intensity.

4. The person’s interpersonal relationships tend to suffer as the behavior goes on or escalates.

5. There is a degree of secrecy to the behavior to the extent that others are consciously or unconsciously kept ‘in the dark’ about the behaviors.

The emotional distress referred to in #1 above can be due to the amount of time spent engaging in the behaviors, the amount of money spent, or other consequences that the behavior leads to:  eg., loss of sleep, measures taken to hide the behavior from others, lost productivity at work, etc.  The emotional isolation in #2 above has to do with a lack of disclosure to others about how the person feels, particularly with respect to not sharing with others how the person really feels emotionally.  The escalation factor in #3 has to do with how the person tends to need greater sexual stimulation or more heightened experiences to get the same emotional charge or rush from the experience.  The last sign has to do with living a ‘double life’ to some extent, which is a reflection of #2 to a large extent.

How to Treat Problem or Out of Control Sexual Behavior:  

There are various ways to treat problem or Out of Control Sexual Behavior.  There are numerous inpatient facilities around the country that are very well-intentioned in trying to help people stop a pattern of what is commonly termed sex addiction.  Many of these are based on a 12-step model of recovery that is very task oriented.  Some of them involve individual therapy or counseling, too.  Eye Movement Desensitization and Reprocessing or EMDR is one therapy modality that can be effective in treating addictive, problem, or out of control sexual behavior.  The 12-step model tends to be a very task oriented approach and relies on the individual developing a spiritual approach to the problem that may or may not be helpful for certain individuals.  It also tends to reinforce a shaming experience related to the issue for others, which can serve to exacerbate the problem as well.  

There is no ‘silver bullet’ that exists to put the problem to rest for once and for all however, and it is my opinion that the search for one can lead to a lot of frustration and feelings of futility on the part of the person, their family, and friends.  

My Approach

My approach to this problem is to use a combination of individual and group therapy to treat the problem.  The individual therapy can involve EMDR, but also involves multiple assessment instruments to help the individual gain a greater awareness of themselves and the context in which the problem originated.  My view is all behavior is adaptive in some way, and the person with the problem or out of control sexual behavior developed this problem as way to cope with certain environmental issues that allowed them to survive in some way at some time in their lives.  Rather than tell someone to just stop and shame them if they haven’t succeeded, I try to work with the person’s own internal motivations to eventually develop a plan of sexual health they can follow for the rest of their lives.  This is the model developed by Doug Braun-Harvey and Michael Vigorito in their book Treating Out of Control Sexual Behavior:  Rethinking Sex Addiction.

I also encourage most men with this problem to eventually participate in an ongoing therapy group to help treat the problem.  I believe that since out of control sexual behavior is fundamentally a social issue, it should be treated socially.  It gives men a chance to be with other men in a way that is supportive and non-shaming, so the broken social connections that have fed the disorder can be restored.  In this way in particular men can begin to heal the wounds that have fed their behavior and work to build lives that are richer and more integrated with sexual health, as well as overall health and well-being.  

I have a group that I am planning on starting this fall with this intention.  It will initially be an 8 week group that will focus on the very principles set out in Doug Braun-Harvey and Michael Vigorito’s book.  If you want more information you call or e-mail me at 512-648-3053 or sj29k@gmail.com.